Biomechanical Changes Following Knee Arthroplasty During Sit-To-Stand Transfers: Systematic Review

J Arthroplasty. 2019 Oct;34(10):2494-2501. doi: 10.1016/j.arth.2019.05.028. Epub 2019 May 21.

Abstract

Background: Knee arthroplasty (KA) is a common and effective surgical procedure that allows patients with knee osteoarthritis to restore functional ability and relieve pain. Sit-to-stand is a common demanding task during activities of daily living and is performed more than 50 times per day. The purpose of this systematic review is to obtain a comprehensive understanding of biomechanical changes during sit-to-stand transfers following KA.

Methods: Relevant articles were selected through MEDLINE (PubMed), Scopus, Embrace, and Web of Science. Articles were included if they met the following inclusion criteria: (1) underwent KA without restriction on the arthroplasty design, (2) involve kinematic, kinetic, or muscle activity variables as the primary outcome measure, (3) evaluated sit-to-stand, and (4) were written in English.

Results: A total of 13 articles were included in the current systematic review. The KA group exhibited altered movement patterns as compared to healthy controls. Considering the time course of recovery, improvement in knee joint kinematics was found up to 2 years but kinetic changes indicate intensified contralateral limb loading. For comparisons for limbs, limb differences were apparent, but those differences were resolved by 1 year.

Conclusion: Despite the inevitable changes in kinematics, kinetics, and muscle activity in sit-to-stand since KA, it appears to be important to restore quadriceps strength for the operative limb in order to minimize risk for subsequent joint problems.

Keywords: EMG; kinematics; kinetics; knee arthroplasty; sit-to-stand; systematic review.

Publication types

  • Systematic Review

MeSH terms

  • Activities of Daily Living*
  • Aged
  • Arthroplasty, Replacement, Knee*
  • Biomechanical Phenomena
  • Female
  • Humans
  • Kinetics
  • Knee Joint / surgery*
  • Male
  • Middle Aged
  • Movement
  • Muscle Strength
  • Osteoarthritis, Knee / surgery*
  • Quadriceps Muscle / surgery*
  • Quality Assurance, Health Care
  • Sitting Position
  • Standing Position